METHODS: A mapping review of pain management programmes and psychological therapies for community-dwelling older people living with chronic pain. We searched for systematic reviews of randomised controlled trials and for individual randomised controlled trials and extracted data from eligible studies.
RESULTS: Searches resulted in 3419 systematic review records and 746 RCT records from which there were 33 eligible interventions identified in 31 eligible RCTs (48 reports). Broad aims of the interventions were to: improve physical, psychological, or social functioning; adjust the effects or sensation of pain psychologically; enhance self-care with self-management skills or knowledge. Common mechanisms of change proposed were self-efficacy enhanced by self-management tasks and skills, using positive psychological skills or refocusing attention to improve responses to pain, and practising physical exercises to improve physiological well-being and reduce restrictions from pain. Content of interventions included: skills training and activity management, education, and physical exercise. Interventions were delivered in person or remotely to individuals or in groups, typically in 1-2 sessions weekly over 5-12 weeks.
CONCLUSIONS: All the evaluated interventions appeared to show potential to provide some benefits to older people. None of the included studies assessed frailty. However, some of the included interventions appear appropriate for community-dwelling older people living with both frailty and pain.
方法:社区居住的慢性疼痛老年人的疼痛管理计划和心理治疗的绘图综述。我们搜索了随机对照试验的系统评价和单个随机对照试验,并从符合条件的研究中提取了数据。
结果:搜索结果产生了3419份系统评价记录和746份RCT记录,在31份符合条件的RCT(48份报告)中确定了33份符合条件的干预措施。干预措施的广泛目标是:改善身体,心理,或社会功能;从心理上调整疼痛的影响或感觉;通过自我管理技能或知识增强自我护理。提出的常见变革机制是通过自我管理任务和技能增强自我效能感,使用积极的心理技能或重新集中注意力来改善对疼痛的反应,并进行体育锻炼以改善生理健康并减少疼痛的限制。干预内容包括:技能培训和活动管理,教育,和体育锻炼。干预措施是亲自或远程提供给个人或团体,通常在5-12周内每周1-2次。
结论:所有评估的干预措施似乎都显示出可能为老年人提供一些益处。纳入的研究均未评估虚弱。然而,所包括的一些干预措施似乎适用于患有虚弱和疼痛的社区居住老年人.